Laserfiche WebLink
c NLL+vcU 6` uw LUU NUNIULK <br /> SAN J E VIkONMENTAL HEALTH D VISIo1d'vICE ) !�)r`tJlla t I <br /> 304 EAST WEBER AVENUE, THIRD FLOOR tt�Vly1�UU � II;;��aa� f <br /> STOCKTON CA 95202 JUN 6(209) 468-3420 2000 <br /> n <br /> PUBLIC RECORDS RELEASE APPLICATIONII<ONMENTAL HEALTH <br /> APPLICANT li 4L4 lc t-.C, BUSINESSIAGENCY_g rCl ZCLt '1 <br /> n G <br /> ADDRESS V -3 l UrYIYYIy VCS. �t�l[ ( ,lam c Y2 C CA <br /> PHONE (910 Q04 - Z2M FACSIMILE (n(Lo ) C;Cc4- Z222 <br /> TENTATIVE'APPOINTMENT DATE"I TIME <br /> (Please give 7 to 10 business days from date of application submittal) <br /> 171 CHECK BOX TO EXPEDITE REQUEST.$78.00 FEyE--REQUEST PROCESSED IN 3 BUSINESS DAYS <br /> SIGNATURE OF APPLICANT `U; DATE (D-LO -W <br /> FILE ADDRESS !i THIS SIDE EHD STAFF USE ONLY <br /> r, PROGRAM ELEMENTS SEARCH <br /> 2--1 o HAeCk LIJ -- L M0 C.,4L_ OF S <br /> 2 - Dt�oT <br /> 1-7 <br /> I <br /> �i <br /> i } <br /> ENVIRONMENTAL HEALTH DIVISION FILES <br /> 'Z. UNDERGROUND TANK(UST)CLEANUP SITE(Lop) ❑ HOUSING ABATEMENT ❑ SOLID WASTE FACILITY <br /> OTHER CLEANUP SITE(NON-LOP) ❑ FOOD FACILITY ❑ SOLID WASTE VEHICLE <br /> 1,;Z� UNDERGROUND TANK(MONITORINGIREMOVAL) ❑ DOG KENNEL ❑ DAIRY <br /> YR`,HAZARDOUS WASTE GENERATOR ❑ CHICKEN RANCH ❑ PKG TREATMENT PLANT <br /> ❑ TIERED PERMITTED FACILITY Cl MOTEIHOTEL ❑ PUMPER TRUCK/YARD/CHEM TOILETS <br /> ❑ TATTOOIBODY PEIRCING ❑ POOLISPA ❑ LAND USE APPLICATION SITES <br /> ❑ MEDICAL WASTE FACILITY - ❑ PUBLIC WATER SYSTEM ❑ OTHER(PLEASE SPECIFY ABOVE) <br /> 1. List up to ten addresses in the,'space above. Select the type(s) of files from the list above by checking <br /> the appropriate box(es). At least one file type MUST be selected. Fax to (209) 464-0138 or mail to the <br /> address indicated above. <br /> 2. EHD will notify the applicant if[any EHD files exist. An appointment for review will be confirmed <br /> approximately five business days but no later than ten (10) days after receipt of application. The files <br /> will be held for a maximum of five business days for review. Appointments should be scheduled <br /> accordingly. <br /> 3. A file that is actively being worked on by EHD staff may not be immediately available for review. A new <br /> application may be submitted when the file is available. <br /> 4. Any file not returned in the same condition as released will be reorganized by EHD staff at the expense <br /> of the applicant. Future file reviews by the same applicant may require a $78.00 deposit prior to review. <br /> 5. `TENTATIVE appointment dates must be confirmed with EHD staff. <br /> 6. Applications received after 3:00 pm will be processed the next business day. <br /> CONFIRMED APPOINTMENT DATE TIME k <br /> DATE CONFIRMED PHONE FAX INITIALS I1 <br /> REVIEWED YES NO REVIEW DATE <br /> En 00 14 OV24100 <br />